Developing a consumer journey map? Don’t miss these 10 components.

Health plans have learned from the retail industry that providing a first-class consumer experience requires time, money and energy. It also requires an understanding of the existing consumer experience, as seen through the eyes of the consumer. That’s why it’s important for health plans to have a consumer journey map to capture the interactions between […]
Read More »

3 analytics deliverables credited with ACO progress

What does it take to create an accountable care organization that meets benchmarks in care delivery and proves to be profitable? Jeff James, Chief Executive Officer at North Carolina-based Wilmington Health, says metrics and analytics allow for his group’s ACO to exist. The ACO was formed as a partnership with Blue Cross Blue Shield of […]
Read More »

Using population metrics to fine-tune your health system

As more and more provider organizations take on the risk associated with attributed populations, they will need to develop capabilities around reviewing and analyzing data. In my last post, I shared how patient-level metrics can impact quality of care. In this post, I’ll discuss how population-level metrics can help health systems focus on critical needs […]
Read More »

Applying patient-level metrics in population management program

The trend of providers taking on care coordination functions that have typically been the domain of payers is an encouraging one. Care coordination is a natural role for provider organizations, who can further their role as change agents for the many patients who need to get engaged in their own health. Care coordination relies on […]
Read More »

In provider networks bigger not necessarily better … or worse

As the health care industry adapts to the Affordable Care Act and value-based care, provider networks and their size are making news. Insurers are ditching large preferred provider organizations in favor of narrower networks. The appeal is easy to see. In a Huffington Post blog, President and CEO of the New York State Health Foundation James […]
Read More »

Centers of Excellence help manage the high cost of congenital heart disease

Most case managers are unfamiliar with congenital heart disease (CHD) or how to identify it. For health plans, that’s a costly problem. CHD is a broad term, encompassing multiple, often complex diagnoses. It is present at birth and can affect the structure of a baby’s heart and how it functions. More than 35,000 children are […]
Read More »

Make wise investments along your journey from volume to value

Executives in provider organizations are often mission-driven, focusing on maintaining and strengthening their institution so that it can continue to provide critical services to its community. It’s important that you’re careful with the resources that are entrusted to you. So you’ve been deliberate as you’ve looked for ways to optimize clinical and financial performance. You’ve […]
Read More »

Four steps to creating engaging member communications

It’s no surprise that a vast majority of consumers feel overwhelmed by their health care — there is a lot to manage. From choosing the right plan and providers, to taking care of preventive screenings, managing conditions and making the right lifestyle choices. Health plans do their best to make the health care journey easier […]
Read More »

Documenting diagnoses makes a difference in care quality.

An often-repeated statistic warns that 8 million Americans have diabetes and don’t know it. There are similar claims about other chronic illnesses, like hypertension and chronic heart failure. If a patient doesn’t know they are missing a diagnosis, their health care provider may not either. The white paper Accurate coding: The foundation of accountable care explains that […]
Read More »

Your journey to a new health care world needs a new mindset

In addition to making value-based care more widespread, health reform legislation in the late 2000s set the stage for a massive influx of newly insured patients. These developments are some of the major reasons that provider leaders like you are looking at ways to adjust your care delivery model. It is in this stage of […]
Read More »

Follow

Get every new post delivered to your Inbox.

Join 6,052 other followers